In September Darling wrote a careful letter to Kline, letting him know that the committee would be traveling to Minneapolis “to make recommendations on the suitability of the Kenny Institute as a proper place to receive large grants for research, teaching, and so forth—not to study or evaluate the Kenny Treatment, as such.” The visitors would want to see facilities and equipment and to talk with the Institute’s medical staff, business administrator, and others responsible for the proposed research and training programs. They “will, of course, hope to see Sister Kenny,” but “they will not be particularly interested in patients except incidentally, nor in demonstrations of the treatment methods.”128 This letter, Pepper told Darling in a private note, “hit the exact note which I had hoped you would.”129
Although the NRC members tried to frame this investigation as an unbiased institutional review, it was impossible for any conciliatory letter to assuage the suspicions of Kenny and her supporters that yet another group of elite physicians was coming to Minnesota to disparage her work. Kenny shrewdly understood that the NRC could act independently of the NFIP. In a letter addressed to “Gentlemen” she presented herself cautiously as a clinical innovator without emotionality or overreaching claims. She asked for several hours to present to the committee the results “of my clinical research” and also invited the group to the Ray-Bell Studios in St. Paul where she would show her “documentary film.” But then, moving from the cooperative to the brash, she added that she would like the committee to forward their “findings … with regard to this presentation” to British Medical Association branches in London, Sydney, Cape Town, Canada, and India, and to the health departments of these countries. In an unfortunate phrase that turned scientists into amanuenses rather than investigators, she noted that there was an “urgent need of a detailed description of my research in muscle anatomy and physiology and bodily mechanics.”130
On September 24 5 committee members began their trip to Minneapolis, arriving by train the following day. They dined that evening with 6 members of Minnesota’s medical school faculty who were “most concerned with the teaching and research in the field of polio” and who represented its varied views.131 Knapp and Cole worked closely and quite effectively with Kenny; Dean Diehl and William O’Brien, the coordinator of the university’s postgraduate courses, were the mediators between the university and the Institute; John McKinley, professor of neuropsychiatry, and Maurice Visscher, professor of physiology, were firmly in the anti-Kenny camp. The group had “a very free discussion” and was later joined by Mayor Kline and Fred Fadell, the Institute’s new public relations manager.132
The next morning the NRC committee went to the Institute where they met Kenny and the business manager of the Institute, some technicians and nurses, and Pohl and a recent medical graduate who was the Institute’s resident physician. After lunch the visitors watched Kenny’s film and then visited the city hospital’s laboratories, which they considered inadequate and poorly equipped.133 Kline was the host of that night’s dinner, and the guests included Kenny, Pohl, Henry Haverstock (father of Kenny’s first patient and secretary of the Institute’s board), and 2 of Kenny’s wealthy local supporters.134
It was a short visit but the NRC committee met all the major players, saw the facilities at the Institute and city hospital, watched Kenny demonstrate her methods, and socialized with her proponents and antagonists. In November, after 2 months of discussion, the NRC committee finished its 21-page report and sent it to O’Connor.
The committee members identified a number of significant problems in the Institute’s organization. The first was politics. They disliked the power exercised by Kline, who they believed was too closely connected with the Fadell agency, which was not only running the Institute’s upcoming fundraising drive but also planning Kline’s 1945 mayoral reelection campaign. Just what the public funds raised in the upcoming Institute drive would be used for seemed to be unclear, even to members of the Institute’s board. In an early draft of its report, the NRC committee had warned that any NFIP funding policy of the Institute might increase “power in the hands of the political interests with obvious dangers of graft and still lowered standards.”135 The committee removed this comment, along with other intemperate phrases, from the final report.
The committee tried to take the idea of the Institute as a research facility seriously but it was difficult for its members to conceive of research without proper laboratory space or to imagine patient care alone as sufficient for a research program. Even the grant’s proponents seemed unable to explain how laboratory evidence would be integrated with clinical observation. The committee was not impressed with the Institute’s facilities or its professional structure. There were, the committee pointed out, few actively involved physicians. Knapp, neurologist Joseph Michaels, and pediatrician Alfred Stoesser, all chiefs of staff at the city hospital and at the Institute, were “largely inactive in the Institute proper” although they did examine patients before they were admitted to the city hospital and were available on call at the Institute. The Institute’s disturbingly close relationship to the local medical community outside the university also suggested inadequate professional supervision. Unlike the university’s teaching hospital, which restricted patient care to physicians on the medical school faculty, the Institute, like most community hospitals, welcomed outside physicians who were allowed to “continue in professional charge” of their patients. The committee noted with disapproval that these physicians had to agree to “cooperate with Kenny procedures.” As for the Institute’s full-time staff, the number of doctors was “grossly inadequate for the number of patients present,” a situation that probably explained the inadequacy of the Institute’s clinical records, which detailed “chiefly Kenny treatment and its results.”136
The committee’s skepticism turned to suspicion in describing John Pohl. During the NRC visit Pohl had not hidden his frustration with both the NFIP and the medical school. He was, the committee noted, the physician most directly involved in policymaking at the Institute, although he worked there only part time, visiting for about an hour on some days. What was clear was that the committee members neither liked nor trusted him. The early report draft noted that when he had been offered the post of Institute superintendent he had asked for a $20,000 salary, an amount that seemed high. While Pohl and other local physicians associated with the Institute might “honestly believe in the technique,” the early draft noted, “the Committee has reason to believe that the motive of personal gain may enter into this picture.”137
“Today the University, Sister Kenny and the students all seem to be dissatisfied,” the committee concluded in its final report. There was “deep and serious disagreement[s] and personal dislike and distrust not only between the groups but also between many of the individuals within each group.” The university wished to continue courses on polio’s treatment “but on a broader basis and with complete academic freedom.” The medical faculty of the University of Minnesota had been “enthusiastic at first” and “impressed in various degrees with the theory and the practice of the Kenny method,” but many were “now hesitant to go along with the movement.” Kenny rejected the idea of broadening the Institute’s courses and instead wanted to teach courses that would “be limited strictly to the Kenny concept and method of treatment.” She also felt the present courses were too short and should be lengthened to 2 years. Yet physical therapists and nurses studying at the Institute expressed wide dissatisfaction with the current courses “as too long for the content.”138
Politics, the committee’s report concluded, were at the heart of these divisions. City officials were “sincerely enthusiastic” but also not “blind to the incidental benefits to Minneapolis, to the Minneapolis General Hospital and to political careers.” Local physicians benefited from an association with the Institute “either directly or indirectly.” Most believed “that the method is productive of some good results” although “some may frown on the dogmatic position of
Sister Kenny” and “some doubt the theory.” The public support on which Kenny and her allies relied was, the committee believed, genuine but naive. Citizens “in favor of anything which will increase the use and spread of the Kenny method not only in Minneapolis but in the United States and throughout the world” were “not aware of existing scientific doubts” and did not “appreciate the complexities of the situation.”139
Finally the committee turned to Kenny herself. She had been hospitable and patient. But she also “revealed certain very significant attitudes to the problem under study.” Not only had she expressed great disapproval of the NFIP and its president but she had “belittled additional research,” stating that “30 years ago she had done all the research necessary.” Yet, notwithstanding such a statement, the grant application had requested funding for “Clinical Research” and “Neurological Research.” The committee was not convinced that Kenny grasped the complexities of polio science. It praised her knowledge of the anatomy involved in her treatment but warned that she lacked “fundamental information of scientific medicine.” As an example the committee cited her statement in the film she showed them that “the muscle is the host to the virus.” Most of all, the committee disliked Kenny’s prominence at the Institute. “Her unusual personality dominates the whole scene,” its final report warned. “She is the Kenny Institute and there is no possibility of the control of anything by anyone else for she controls everything and everybody. Her statements are empiric and final; there is no argument.”140
The NFIP, the committee concluded, should not dissociate itself from the Institute, partly in order to protect “what is good in the Kenny method” from being “lost through unfortunate associations,” and partly because the committee feared that if the Institute’s fundraising campaign expanded “the duplication of nationwide drives” it would have “an effect upon public confidence.” The Institute, in the NRC committee’s view, was not and could not be a proper site for scientific research. The NFIP should promote Kenny’s work only in the narrowest sense: as a useful method that should be available to American patients treated by properly trained technicians. The NFIP should continue to fund courses for technicians, but it should make sure that all applicants were qualified physical therapists, not nurses without physical therapy training. No money should be given to the Institute for the maintenance of patients used solely as teaching or research subjects. And, most important, there should be no grant for either basic or clinical research unless the Institute, at some time in the future, could provide “conclusive evidence of a competent investigative staff and adequate laboratory facilities.”141
The NFIP thanked the NRC committee for their work but did not immediately respond to the Institute. It kept the NRC report secret, as the NRC committee had requested, and continued to watch the responses in Minnesota.
PENNIES FOR KENNY
In November 1944 the Institute’s board of directors, confident that a public movement was behind them, organized the first separate Kenny campaign. The NRC was just finishing its report and it seemed likely that it would lead to a rejection by the NFIP, but nothing had been publicly announced. The Kenny campaign was coordinated by a public relations firm based in Minneapolis, and its slogan was “Pennies for Kenny.” Kenny reigned as the campaign’s celebrity.142 Although the drive was restricted to Minnesota, she went on tour, taking with her a new technical film demonstrating her work at the Institute. Dressed in black lace with orchids on her shoulder and accompanied by Mary Kenny, Kenny entered auditoriums and ballrooms to low murmurs of “there she is,” “look, there is Sister Kenny,” “here she comes.”143
She used this tour not only to attack the NFIP and laud the Institute but also to reposition herself in race politics. During the late 1930s the NFIP had scrambled to respond to civil rights activists who pointed to the neglect of black polio survivors. Convinced by Warm Springs’ white trustees that the center should remain a whites-only institution, the NFIP had established a small polio hospital at the Tuskegee Institute that opened in 1941. It was designed to be both a treatment center and a place to train African American orthopedic physicians, nurses, and physical therapists unable to gain access to specialty training programs in hospitals around the country.
During the war an emerging African American middle class helped to make problems of polio care visible, especially the racist policies implicit in almost all hospital care. Some municipal public hospitals such as the Minneapolis General Hospital admitted both white and black poor patients; most private hospitals were restricted to white paying patients. Initially affiliated with the city hospital, Kenny had accepted African American patients from the outset, as the Reader’s Digest’s depiction of Suzy had shown.144 With the founding of the Institute, a city building under the supervision of the city’s board of welfare, Kenny continued to accept both black and white child patients and also a few African American nurses for training, such as Chicago nurse Lulu Boswell who later worked at the Tuskegee polio hospital.145 In other cities indigent black patients with polio received the Kenny method in public infectious diseases hospitals such as the Isolation Hospital in Memphis.146 References to Kenny and her work began to appear more frequently in the black press. The Chicago Defender featured a photograph of a grinning 11-year-old Jean Andrews on her way to Minneapolis to receive treatment at the Institute, and one of its health columns praised the Kenny treatment as “undoubtedly helpful in lessening the paralytic deformities.”147 Before the end of the war there were only a few black celebrities involved with polio fundraising. But in 1943 African American boxer Ray Robinson, an enthusiastic supporter of March of Dimes campaigns, was featured in the New York Amsterdam News in a story about a black girl who “was among the first to be benefited by the Kenny treatment at the Minneapolis General Hospital.”148
The racist assumptions Kenny had grown up with were clearly visible in her autobiography where she portrayed Australian Aborigines as savage and comic.149 In other remarks publicized in 1943 Kenny had referred to the limited number of black patients she had treated by noting the possible shielding affects of “pigment.”150 Such views were not challenged by the white businessmen and professionals she worked with in Minnesota. During the 1944 drive, however, perhaps pressured by the Fadell firm, Kenny became more aware of the importance of race politics in polio. After she showed her film in Washington, D.C. she proudly quoted a statement from John W. Lawlah, the dean of Howard University’s medical school, that “there is no mistaking the results which we have seen in this picture … it is up to us as scientists to follow the lead Sister Kenny has given.”151
In Minnesota the organizers of the 1944 campaign sought the support of local African Americans. Milton G. Williams, the black publisher and editor of the Twin City Observer, agreed to work as the campaign’s state chairman of “Negro participation.” The Observer, a Republican paper for black Minnesotans, set up a campaign committee and published pictures of Kenny and her Institute. Williams’ editorials noted that the Institute had treated “a number of Negro children” and that in Minneapolis her treatment had “been given to all and sundry regardless of race and creed.”152 Kenny appeared at a meeting at the St. James A.M.E. Church in St. Paul where she “held the audience spellbound as she reviewed her struggles to initiate her treatment of polio.” She asked that “a Negro physician” come to her Institute “to learn her system” and showed part of her film featuring a black girl treated at the Institute.153
Despite its entry into race politics, the campaign’s most successful appeal was to white Minnesotans, especially white Republicans. Cans bearing the slogans “Pennies for Kenny” and “Give, and Be Thankful They Shall Walk” appeared at private bridge parties, movie nights, and society teas. Funds were raised at a wrestling show, a boxing match, bowling lanes, and the annual Gopher football dinner. The state’s Republican Party made the campaign part of its annual charitable program, and the Minneapolis Association of Manufacturers donated the proceeds of its annual tra
de dinner at the Radisson hotel to the Institute.154
Earlier that month Mayor Kline had been accused of ignoring the “open flaunting” of the city’s gambling and liquor laws and had appeared before a Hennepin County grand jury where he declared that he would not “tolerate any type of pay-offs.”155 Kline’s connections with liquor dealers, nonetheless, helped him convince Earl Haskin, the state liquor commissioner, to become honorary chairmen of the Kenny campaign’s liquor industry division. When the campaign organizers declared November 21 as Sister Kenny Day, liquor dealers in the state agreed to donate 25 percent or more of their gross receipts for the day.156
During the November campaign Reader’s Digest published “Sister Kenny vs. The Medical Old Guard” by Lois Miller. There was no effort to balance this story with statements from skeptical physicians: here were unambiguous heroes and villains. Kenny’s work was “revolutionary,” Miller announced confidently, for “it discards previous concepts and treatments.” And it was more than a departure from clinical practice: it threatened the hierarchy and complacency of the medical profession, for “it was developed not by a doctor, but by a nurse.” Kenny, “a strong-minded woman” with “no time for politics” did have, Miller admitted, “an unfortunate faculty for treading heavily on sensitive toes.” Miller retold the AMA report as part of Kenny’s “long struggle against stubborn and reactionary elements in the medical profession.” The AMA committee, Miller argued, had urged physicians to reject the Kenny treatment but offered “nothing in its place other than a return to the old method of using splints and braces.” In fact, Kenny’s methods were in widespread use although—in phrases that sounded just like Kenny—“not always used properly” as many technicians and nurses “have not had sufficient training or experience.” The minority who continued to decry the Kenny treatment admitted that “they had no firsthand knowledge of it” and “had never tried it clinically.” During heated debates at the 1944 AMA meeting, one doctor said “I wonder what we have on trial here—Sister Kenny’s personality or the Kenny treatment.”157 Miller did not repeat Kenny’s comment about the economic basis of orthopedists’ antagonism, but she did use evidence Kenny often quoted: the closing of 2 classrooms by the Michael Dowling School in Minneapolis, a school for physically disabled children unable to attend public schools. The rooms were no longer needed because all 91 patients with polio paralyzed between 1940 and 1943 were able to return to their regular schools.158 It was a powerful comparison between an ordinary schoolroom filled with able-bodied children and empty classrooms where despondent crippled children were once confined.
Polio Wars Page 42